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One additional exposure related to a retailer was identified and four food items where all cases had been exposed. In conclusion, the case-background method, a development of the case-case design, can be used to assist with hypothesis generation or when a case-control study may not be possible to carry out.BACKGROUND Knee osteoarthritis is a common, chronic condition and main contributor to global disability. Total knee arthroplasty (TKA) is the most successful treatment for end-stage knee osteoarthritis. It is assumed that in the field of surgery, there is a relationship between hospital volume and health outcomes and that higher hospital volume results in better health outcomes. As a consequence, minimum volume thresholds have been implemented in Germany for various procedures, including TKA (50 procedures per year). To date, it is unclear whether minimum volume thresholds truly result in better outcomes. The objective of this study will be to quantify the relationship between hospital volume and patient-relevant outcomes in patients undergoing TKA. METHODS We will include published or unpublished (cluster-) randomized controlled trials and prospective or retrospective cohort studies that involve patients with primary and/or revision TKA, report at least two different hospital volumes and report at least one ndings of our systematic review will probably be limited by the design of the included studies. We do not expect to identify any (cluster-) randomized controlled trials that meet our inclusion criteria. Therefore, the best available evidence included in our systematic review will most likely consist of cohort studies only. We anticipate that the results of this study will inform future health policy decisions in Germany regarding the minimum volume threshold for TKA. Systematic review registration PROSPERO CRD42019131209.BACKGROUND In 2014, an outbreak of adenoviral pneumonia occurred in the Korean military training center. However, there are limited data on the characteristics of the fever and its response to antipyretic therapy in immunocompetent adults with adenovirus-positive community-acquired pneumonia (CAP). METHODS The medical records of the patients who were admitted to the Armed Forces Chuncheon Hospital for the treatment of CAP between January 2014 and December 2016 were retrospectively analyzed. The patients were divided into three groups, namely, the adenovirus-positive (Adv) group, the adenovirus-negative (Non-Adv) group and the unknown pathogen group, according to the results of a polymerase chain reaction (PCR) test and sputum culture used to measure adenovirus and other bacteria or viruses in respiratory specimens. We evaluated and compared the demographics, clinicolaboratory findings and radiological findings upon admission between the two groups. read more RESULTS Out of the 251 military personnel with CAP during thecal stabilization was significantly longer in the patients in the Adv group than in those in the Non-Adv group (4.3 ± 2.8 vs. 2.9 ± 1.8 days, P = 0.034, respectively). Furthermore, no significant difference in the length of hospital stay was observed between the two groups, and no patient died in either group. CONCLUSION In this study, Adv-positive CAP in immunocompetent military personnel patients had distinct fever characteristics and responses to antipyretic treatment.BACKGROUND Tobacco use, correlated with reduced physical fitness, is one of the leading causes of avoidable death worldwide. It increases the risk of dementia and can shorten the lifespan by 10 years. For the German Armed Forces (Bundeswehr), figures on smoking behavior have not been comprehensively captured. This study analyzes current data in a large sample from this population. METHODS Based on an employee survey as part of the Occupational Health Management System, data on smoking behavior from 13,326 participants were analyzed in relation to age, gender, professional status, education level and membership in military operational units versus other agencies. RESULTS Smoking behavior varied significantly (P  older), gender, professional status, military agency membership status, and education level (the lower the education level, the higher the smoking rates). With the exception of the downward trend in smoking behavior with increasing age among civilian employees, these results were all significant (P  less then  0.005). CONCLUSIONS This data analysis shows that smoking prevalence among personnel in the area of responsibility of the Federal Ministry of Defense is comparable to the current data from corresponding surveys of the German population. Depending on gender, they generally show values that are slightly above those of the German population. The well-known trend in the general population of decreasing smoking prevalence with increasing age is also seen in this analysis. However, there are considerable differences in the smoking prevalence among individual subgroups (professional status, agency, gender, education level). The data show that particular young soldiers in the armed forces should be the target group for further preventive measures.BACKGROUND Surgical site infections (SSIs) are among the most common healthcare-associated infections. Under-nutrition is an important risk factor for SSIs and can lead to delayed wound healing and longer hospital stays. Oral nutritional supplements are prescribed to reduce the risk of infection and improve health status, but data from randomised controlled trials (RCTs) have shown mixed results. Thus, the objective of our planned systematic review is to evaluate oral nutritional supplements on preventing SSIs in adult surgical patients METHODS RCTs conducted in adult surgical patients who receive oral nutritional support will be included. The primary outcome will be the incidence of SSIs (within 30 days of surgery or within 90 days for joint replacement surgery). Secondary outcomes will be changes in nutritional status, mortality, health-related quality of life and costs. Literature searches will be conducted in several electronic databases (from inception onwards) MEDLINE, Embase, CINAHL and The Cochrane Central Register of Controlled Trials (CENTRAL).